OPIN Cat Adoption Application

Prerequisites

To adopt, you must be at least 21 years old, have the knowledge and consent of all adults living in your home, and be willing and able to spend the time and money needed to provide the dog with training, vet treatment and proper care. Completion of this application doesn’t guarantee adoption approval. We reserve the right to approve or deny any adoption.

Name of Cat: *

To adopt, you must check that you agree to all of the below:

be at least 21 years old

have the knowledge and consent of all adults living in your home

be able & willing to spend the time & money needed to provide the cat with proper care & vet treatment

be able & willing to make a non-refundable donation of $125 to OPIN for the cat adoption.

Completion of this application doesn’t guarantee adoption approval.

Your Name: *

Your Name:

First Name

Last Name

Your date of birth: *

Your date of birth:

MM

DD

YYYY

Name of Spouse, Partner, or Roommate:

Name of Spouse, Partner, or Roommate:

First Name

Last Name

Your Address: *

Your Address:

Tip: This is a system generated form, it has a bug in that it requires the "Address 2" field to be populated with something and not everyone has an Address 2. Please enter a "-" (dash) in Address 2 area if you do not have an Address 2.

Address 1

Address 2

City

State/Province

Zip/Postal Code

Country

Home Phone:

Home Phone:

(###)

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####

Work Phone:

Work Phone:

(###)

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Mobile Phone:

Mobile Phone:

(###)

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Email Address: *

Your Place of Employment: *

Spouse/partner’s place of employment:

Hours applicant works per day

Applicant Start Work Time: *

Applicant Start Work Time:

Hour

Minute

Second

Applicant End Work Time: *

Applicant End Work Time:

Hour

Minute

Second

Hours spouse/partner works per day

Spouse/Partner Start Work Time:

Spouse/Partner Start Work Time:

Hour

Minute

Second

Spouse / Partner End Work Time:

Spouse / Partner End Work Time:

Hour

Minute

Second

About Your Household

How many adults are in your home? *

1 adult

2 adults

3 adults

4 adults

5 adults

More than 5 adults

How many children are in your home? *

No children

1 child

2 children

3 children

4 children

5 children

More than 5 childredn

If you have children in the home what are their age(s)?

How does your spouse/partner feel about adopting this cat?

Is any household member allergic to animals? *

Yes

No

If yes to allergies, how will you deal with reactions to this pet?

Do you have any dogs? *

Yes

No

If yes, how many dogs are in the house?

1 dog

2 dogs

3 dogs

More than 3 dogs

Have the dog(s) lived with a cat before?

Yes, my dog(s) have lived with a cat before.

Some of my dog(s) have lived with a cat before.

No, my dog(s) have never lived with a cat before.

Some questions about adopting

Where did you hear about OPIN and the pet or adoption? *

Why do you want to adopt a cat/kitten?

Why did you choose this particular breed/mix of cat?

Will the adopted cat be:

Indoor only

Outdoor only

Both Indoor and Outdoor

Have you ever owned a cat?

Yes

No

If "yes" do you still have it?

Yes

No

If no longer have a cat, what happened to the cat?

Have you ever given a pet to a shelter or to someone else? *

Yes

No

If yes, please explain:

Have you ever had a pet euthanized? *

Yes

No

If yes, please explain:

Have you ever owned a declawed cat, or had a cat declawed?

Yes

No

If yes, give the reason:

Would you ever declaw the cat/kitten you want to adopt (if not declawed upon adoption)? *

Are you FINANCIALLY ABLE to spend this kind of money on this cat if required? *

Yes

No

Are you COMMITTED to spend this kind of money on this cat if required? *

Yes

No

Cats can live 15 years or longer. Can you commit to caring for this pet for that long? *

Yes

No

Will you give all required medical care necessary for the life time of this pet?

Yes

No

What provisions will you make for the cat should you become unable to care for him/her?

Under what circumstances would you give up the cat?

What will you do with the cat if you have to move?

What will you do with the cat if you have a baby?

Will you work out bad habits (scratching, biting, house-soiling, etc.) the cat may have?

Yes

No

If yes, how are you planning on dealing with any bad habit?

On your own

Hiring a trainer

If you go away for a few days, or on a vacation, who will take care of the cat?

Are you willing to take responsibility for this cat for the next 15 years or more? *

Yes

No

If no, explain:

About your home

Do you own or rent your home?

Own

Rent

How long have you lived at your current address?

Less than 6 months

6 months to 1 year

1 year - 2 years

3 years to 4 years

5 years to 6 years

over 6 years

Do you live in a: *

House

Apartment

Condo

Townhouse

Other

If other please explain:

If you rent, provide name and telephone number of your landlord.

Landlord Name:

Landlord Name:

First Name

Last Name

Landlord Phone:

Landlord Phone:

(###)

###

####

If you rent, please show us the part of your lease where you are allowed to have pets, the number allowed and any limitation in size weight, if any. If pets are not mentioned in your lease, please ask us for the “Permission to Have Pets” form and have it signed by your landlord and fax it to us.

If you own, you must provide proof of ownership by a copy of your Real Estate Tax Bill, or by showing us your mortgage prior to paying adoption fees. Owners of condos or townhouses must also provide a copy of the condo association’s by-laws indicating pets are allowed, the number allowed and any limitations in size or weight, if any.

Please provide references of two people (not in your family) who have known you 5 years or more:

Personal Reference 1: *

Personal Reference 1:

First Name

Last Name

Personal Reference 1 Phone:

Personal Reference 1 Phone:

(###)

###

####

Personal Reference 2: *

Personal Reference 2:

First Name

Last Name

Personal Reference 2 Phone:

Personal Reference 2 Phone:

(###)

###

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Present and Former Veterinarians

Name of your PRESENT Veterinarian & Hospital:

City and phone number (Present Vet):

Name your pet records are under at your present vet (if different than applicant):

Name of your FORMER Veterinarian & Hospital:

City and phone number (Former Vet):

Name your pet records are under at your former vet (if different than applicant):

More about animals, currently in home, if any.

Give us information about all the animals alive and currently living in your household: *

Give us information about the last 3 animals that you no longer have (deceased or otherwise): *

Name of Pet Dog/Cat/Other, Breed, Sex, What happened to pet? If dead, how did it die? If dead, age at death, Date of death or surrender

Additional comments from applicant:

PLEASE READ CAREFULLY BEFORE SIGNING FEES:

There is $125.00 non-refundable adoption donation to be paid by cash or check. This donation
goes towards off-setting the cost of the spay/neuter surgery, vaccination, micro-chipping, and boarding
costs. All donations above this amount are very welcome, and greatly appreciated, as our costs per pet are
greater than the adoption fee. In addition, we rely on donations to be able to save the next pet in need.
HOME VISITS: OPIN may choose to perform both pre-adoption and post-adoption home visits.

USE OF CAT:

You agree that the cat will be adopted as a house pet and companion only. OPIN reserves
the right to reclaim the cat if it feels the dog is not being fed, housed or cared for to its satisfaction. If you
are unable to care for this cat, he/she must be returned to OPIN.
COPY OF DRIVER’S LICENSE (or other form of official ID) IS REQUIRED
This application is designed to help us determine if the adoption is in the cat’s best interest, and to assist
you in finding a pet compatible with your lifestyle. An unwise adoption can result in an unpleasant
experience for adoptive families and may ruin the pet for further adoptions. We hope you will agree that
the pet’s welfare must be our foremost concern.
I understand the above questions and I authorize investigation of all statements contained in this
application. I understand that misrepresentation or omission of facts is cause for denial of adoption.
By signing this application, I am stating that the above mentioned is true.

Your Signature

Entering your name here will count as an electronic signature however you will also be required to sign this agreement on paper in person.

Your Signature *

Your Signature

Enter your name.

First Name

Last Name

Today's Date *

Today's Date

Enter today's date.

MM

DD

YYYY

If you have filled out all of the above please click the submit button.

Below is For OPIN Use Only

For opin Use Only . Applicants please proceed to click the Submit button below.

Final comments:

For OPIN Use Only

Status:

For OPIN Use Only

Approved

Denied

Denied by:

For OPIN use only. Applicants please click the submit button.

Date of Decision:

Date of Decision:

For OPIN use only. Applicants please click the submit button.

MM

DD

YYYY

Thank you for submitting an application to adopt a cat from OPIN. You will hear from us shortly.

OPIN - Outreach to Pets in Need

OPIN (Outreach to Pets in Need) is an all-volunteer registered 501(c)(3) non-profit. Our mission is to promote adoption of homeless animals, and to provide assistance to pets in need through medical treatment, training, and education. We are in the Stamford, CT area.

OPIN was co-founded by shelter volunteers and is an all-volunteer registered 501(c)(3) non-profit. Our mission is to promote adoption of homeless animals, and to provide assistance to pets in need through medical treatment, training, and education.